Current Strategies and Novel Drug Approaches for Alzheimer Disease

CNS Neurol Disord Drug Targets. 2020;19(9):676-690. doi: 10.2174/1871527319666200717091513.

Abstract

Alzheimer's Disease (AD) is a chronic, devastating dysfunction of neurons in the brain leading to dementia. It mainly arises due to neuronal injury in the cerebral cortex and hippocampus area of the brain and is clinically manifested as a progressive mental failure, disordered cognitive functions, personality changes, reduced verbal fluency and impairment of speech. The pathology behind AD is the formation of intraneuronal fibrillary tangles, deposition of amyloid plaque and decline in choline acetyltransferase and loss of cholinergic neurons. Tragically, the disease cannot be cured, but its progression can be halted. Various cholinesterase inhibitors available in the market like Tacrine, Donepezil, Galantamine, Rivastigmine, etc. are being used to manage the symptoms of Alzheimer's disease. The paper's objective is to throw light not only on the cellular/genetic basis of the disease, but also on the current trends and various strategies of treatment including the use of phytopharmaceuticals and nutraceuticals. Enormous literature survey was conducted and published articles of PubMed, Scifinder, Google Scholar, Clinical Trials.org and Alzheimer Association reports were studied intensively to consolidate the information on the strategies available to combat Alzheimer's disease. Currently, several strategies are being investigated for the treatment of Alzheimer's disease. Immunotherapies targeting amyloid-beta plaques, tau protein and neural pathways are undergoing clinical trials. Moreover, antisense oligonucleotide methodologies are being approached as therapies for its management. Phytopharmaceuticals and nutraceuticals are also gaining attention in overcoming the symptoms related to AD. The present review article concludes that novel and traditional therapies simultaneously promise future hope for AD treatment.

Keywords: Amyloid plaque; antisense oligonucleotides; neurofibrillary tangles; nutraceuticals; phytopharmaceuticals; tau protein.

Publication types

  • Review

MeSH terms

  • Alzheimer Disease / drug therapy*
  • Amyloid beta-Peptides / metabolism
  • Animals
  • Brain / metabolism
  • Cholinesterase Inhibitors / therapeutic use
  • Donepezil / therapeutic use
  • Galantamine / therapeutic use
  • Humans
  • Mice
  • Phytotherapy / methods
  • Plant Preparations
  • Rats
  • Rivastigmine / therapeutic use

Substances

  • Amyloid beta-Peptides
  • Cholinesterase Inhibitors
  • Plant Preparations
  • Galantamine
  • Donepezil
  • Rivastigmine